The History of Supervision: A Critical Review

Data-Driven Monitoring in Community Based Management of Children With Severely Acute Malnutrition (SAM) Using Psychometric Techniques: An Operational Framework

Background The success of the Community Based Management of Severe Malnutrition (CSAM) programme largely depends on the knowledge and skills of Front-Line Workers (FLWs). A robust supportive supervision system in CSAM should be tailored to individualistic learning needs by distinguishing the FLWs as per their ability and simultaneously identifying the task domains to be emphasized more in supervisory visits. This paper details the ability assessment strategy developed and employed in the selected geographical locations in Madhya Pradesh (Central India) among the 197 Anganwadi workers (FLWs involved in CSAM implementation). Methodology A 25 items tool was developed based on an analytical construct for ability estimation through Rasch Analysis (RA). RA models the probability of right/wrong answers as a function of a person (participants) and item (questions) parameters and calculates the item difficulty in relation to personability on the same unidimensional linear scale. Suitable visualization like item characteristic curve (ICC), person item map (PIM) and quadratic allocation were plotted in RA. The data fitting to the Rasch model (Rasch diagnostic) was tested by numeric (Anderson LR and Wald test) and graphical methods. Results The item easiness parameter (β) value related to Diarrhoeal assessment was lowest (-2.32, -2.91 to -1.73) and related to peer assessment meaningful action (2.009, 1.669- 2.348)) was highest (most difficult). Anderson LR test (LR=31.32, df=24, p=0.079) showed the absence of global outliers. Quadrant analysis using the permutations of ability score and adjusted burden of malnutrition further mapped 41/197 (20.8%) FLWs to low ability -high burden quadrant and 44/197(25%) as low ability low burden quadrant. Conclusion Rasch assessment may address the innate challenges to maintain homogeneity, discrimination capacity and linearity in a raw score-based measurement construct. The monitoring strategy developed on this thus may offer a judicious, pragmatic and thematic approach to supportive supervision in the CSAM program.

Supervision in Occupational Therapy, Part 1: The Supervisor's Anxieties

Supervision, as a research field, has received a considerable amount of attention within counselling psychology, social work and psychotherapy. Although there is no lack of theoretical writings on supervision within these disciplines, the theories themselves have provided little guidance for continuing research and practice. This has resulted in confusion concerning the purpose of supervision, its distinctiveness from other similar activities, the role and function of the respective participants in the process, and the tasks and methods to be employed.

This paper, the first of three on the experience of supervision in occupational therapy, describes a grounded theory study which set out to investigate the processes underlying supervision in the discipline of occupational therapy from the perspective of the supervisor. The data were collected by interviewing 30 occupational therapy supervisors in the South West of England. The results suggest that supervision is frequently experienced as an uncomfortable and relatively unproductive process within this occupational group. In addition, the data lend support to the possible existence of an egalitarian relationship which operates between supervisor and supervisee, with associated payoffs and risks for each participant in the relationship.

A second paper reporting the supervisee's perspective will be published as part 2, together with recommendations for future practice in part 3.

Using the tenets of the problem-centered systems therapy of the family (PCSTF) to teach the McMaster Approach to family therapists

This article describes the videoconferencing training of a group of family therapists in the McMaster Approach to evaluating and treating families. A discussion of the key tenets of the McMaster Approach lays the groundwork for how these tenets were applied to training in a residential treatment agency for adolescents. The article serves as an example of how videoconference technology can facilitate extended training, even from a distance.

Clinical Supervision in Four Mental Health Professions: A Review of the Evidence

This paper examines a range of theoretical issues and the empirical evidence relating to clinical supervision in four mental health professions, namely clinical psychology, occupational therapy, social work, and speech pathology. Despite the widespread acceptance of the value of supervision among practitioners and the large quantity of literature on the topic, there is very little empirical evidence in this area. It is not clear whether supervision actually produces a change in clinician behaviour, nor whether it produces benefits in terms of client outcomes. To date, there is insufficient evidence to demonstrate which styles of supervision are most beneficial for particular types of staff, in terms of their level of experience or learning style. The data suggest that directive forms of supervision, rather than unstructured approaches, are preferred by relatively inexperienced practitioners, and that experienced clinicians also value direct supervision methods when learning new skills or dealing with complex or crisis situations. The available evidence suggests that supervisors typically receive little training in supervision methods. However, to date, we have little information to guide us as to the most effective ways of training supervisors. While acknowledging the urgent need for research, the paper concludes that supervision is likely to form a valuable component of professional development for mental health professionals.

Toward a common-factors approach to supervision

Despite the proliferation of supervision models, there is no evidence to suggest that any one model of supervision is in any way superior to any other. Many in the field have called for models that can bridge the various theoretical approaches to clinical supervision, and identify the essential elements of supervision. This article briefly explores the range of existing supervision models, and suggests a rationale for seeking factors common across the various models. The authors highlight the development of a new supervision model that synthesizes current thinking about supervision into three dimensions. The three dimensions are defined, and resulting supervisory roles explored. Implications for supervision practice, research, and training are discussed.

John Heron's six-category intervention analysis: towards understanding interpersonal relations and progressing the delivery of clinical supervision for mental health nursing in the United Kingdom

AIMS

This paper provides a critique of how Heron's six-category intervention analysis framework has been adopted by nursing in the United Kingdom (UK) as a theoretical framework in nursing research and model for clinical supervision. From this, its merits as an analytic framework and model for clinical supervision in nursing are discussed.

BACKGROUND

Heron's six-category intervention analysis has been acknowledged as a means by which nursing could develop its therapeutic integrity. It has also been used as a theoretical framework in nursing research focusing on nurses' perceptions of their interpersonal style. More recently descriptions of this framework have been proposed as a structure for clinical supervision. However, its use as a theoretical framework to underpin research investigating the interpersonal skills of nurses and as a model of clinical supervision must firstly be scrutinized.

FINDINGS

Returning to Heron's original description and comparing this with its current adoption in the UK, misconceptions of this framework can be identified. Its value as an analytic tool investigating interpersonal relations in nursing has still to be evaluated. Furthermore, nursing's emphasis on certain intervention categories has undermined the potential potency of this framework and its contribution as a model for clinical supervision in nursing.

CONCLUSION

We argue that Heron's six-category intervention analysis as a framework to investigate the interpersonal competence of nurses, particularly mental health nurses, requires investigation. This, in turn, would provide an opportunity to challenge the framework's theoretical standpoint. In addition to its value as an analytic tool, all six categories of Heron's framework have equal relevance to its contribution in nursing as a supervision model.

Lost in the crucible of supportive clinical supervision: supervision is not therapy

Clinical supervision as a mechanism that supports both professional and personal development is a concept that has captured the imagination of nurses. Though nurses generally agree that 'supervision is not therapy', a clear distinction cannot be enunciated between these two processes when both aim at personal growth. In combining personal and professional growth, the rationale for clinical supervision is unnecessarily confused, with the unfortunate result that supervision may, unwittingly, become a form of therapy for nurses. This paper examines a model of supportive clinical supervision qua Chambers and Long's example of a facilitative therapeutic supervisory style, that reflects nurses' conceptualization of clinical supervision as enhancing personal and professional growth. However, it could be argued that this stance is in crucial respects incorrect, and needs to be rethought if clinical supervision is to be established as credible in nursing. Subsequently, it is important to remember that the utilization of certain techniques rather than their stated goals, will dictate the form that supervision, or therapy, will take. The purpose of this paper is to demonstrate the logical unacceptability in combining two processes as one, while developing a conceptual framework that differentiates supervision from therapy.

The role of the psychologist on the drug user treatment team

Current practice in drug user treatment tends to provide, within any one agency, essentially the same treatment for all clients entering that agency. Instead, an agency should use a team approach, with a specific and unique treatment plan for every client, provided by the members of the team. The psychologist should play a central role on this team, being responsible for the treatment plan, for an individual evaluation plan, for assessing progress, for program evaluation, and, in many instances, for supervision of treatment staff. The functions and the different roles played by the psychologist are described, and the characteristics and skills needed for success are listed.

The nature of clinical supervision in psychiatric nursing: a survey of clinical specialists

There is a growing body of theory and research on clinical supervision within other mental health disciplines; however, there has been little study of clinical supervision within psychiatric mental health nursing. This article reports the results of a survey of 61 psychiatric mental health specialists to determine their attitudes toward selected supervisory issues. Two-thirds of the respondents had received further supervision beyond the master's degree, one-half reported a personal psychotherapy experience, and one-half were certified in psychiatric mental health nursing. There were significant differences of opinion between clinical nurse specialists who were certified and those who were not and between those who reported a personal therapy experience and those who did not. The authors suggest that more attention be paid to the development of curriculum content regarding clinical supervision in graduate nursing programs. In addition, they recommend further research on the topic of clinical supervision in psychiatric mental health nursing.